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General NPI Number Information
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NPI Number | 1770996753
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Entity Type | Individual
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Provider Name | NICOLE L. SECKINGTON N.P.
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Gender | Female
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Dates
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Enumeration Date | 06/06/2014
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 251 SKAGGS RD
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City | BRANSON
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State | MO
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Zip | 65616-2031
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Country | US
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Telephone | 417-483-3627
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1037
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City | LOWELL
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State | AR
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Zip | 72745-1037
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2010019240
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License Number State | MO
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